Diagnosis and treatment of infantile hemangioma
Hemangioma is one of the most common diseases in infants and young children, many parents for the baby's treatment of headache. So how to diagnose, how to treat it best? First, I suggest that parents find an experienced hemangioma doctors diagnosed hemangioma type, in order to facilitate for the treatment of hemangioma, choose hemangioma treatment method, make the treatment of hemangioma to lay the solid foundation. Because different types of hemangioma treatment methods are not the same, the illness and treatment, for patients with different given different individualized treatment is the most ideal.
Let us first to understand the types of infantile hemangioma, which is mainly divided into the following types:
A strawberry hemangioma:
Incidence of neonatal accounted for about 1 \%, more than at the time of birth is, a small red spots, increase gradually later, often higher than the skin, bright red color, lobulated, such as strawberries and red bayberry. The growth was most commonly seen in the head and face, trunk.
Two, capillary hemangioma:
Primary lesion has punctate or patchy large capillary protruding outside the skin, uneven skin, development express, if not timely treatment and control in short time (half a year), will make the already suffering from hemangioma around the organs or organ damage, few can rapid development for mixed hemangioma
Three, PWS
Nevus flammeus, also known as port wine stains or telangiectasia nevus, often at birth or soon after birth, good hair in the face, neck and scalp, mostly for the unilateral, even for bilateral, sometimes involving the mucous membrane. Early damage from sizes or number of pink, red or purple red spots tablets, irregular in shape, clear boundary, not higher than the leather, visible telangiectasia, pressure of partially or completely fade surface is smooth. With the growth of the age, the color deepened turned red, purple, 65% of patients with lesions will gradually expand, before the age of 40 can be thickening and nodules, on trauma easy bleeding. PWS is composed of numerous dilated capillaries is higher than that of flat and rarely elevated patches, which belongs to the congenital vascular malformation. The area of the lesion increased with the growth of the body, and the life was not dissipated. PWS can occur at any site, but more common on the face and neck, 75% - 80%, the unilateral and the right. PWS involved the eyes through the maxillary nerve and when there is a 15% chance with refractory glaucoma. In the PWS patients, 1% - 2% with the same side of the pial vascular malformation, called Sturge-Weber syndrome
Four angiocavernoma
Any part of the cavernous hemangioma can be made in the body, which can be located on the body surface, can also occur in various internal organs, especially the limbs, trunk and parotid. Skin of tumor normal or a dark blue, touch the soft like a sponge, press the masses can be compressed, the private prosecution of the patient suffering from heavy limb, ache, activity significantly. Part of the surface of the cavernous hemangioma of the skin can be combined with capillary hemangioma, called mixed hemangioma. A portion of the parotid gland hemangioma in patients with parotid gland skin surface or other parts of the capillary hemangioma, so of infantile parotid masses not clear reason, if it is found that the presence of capillary hemangioma of skin surface should be considered the diagnosis of parotid gland hemangioma.
Five, mixed type hemangioma
At the beginning of the mostly skin surface ranging in size from small erythema, and pure strawberry hemangioma is not strange, but along with the development of tumor on the surface of blood vessels, while the invasion of dermis and subcutaneous tissue, encroach subcutaneous range can be over the surface of the lesion area, form a bulge mass, irregular shape, more common in the face, arms and legs. Covered with extension sometimes is very wide, so that the tissues and organs of the eyes, lips, nose or ears are the continuous expansion of the vascular tissue can be caused by breathing, eating, drinking, such as visual and auditory dysfunction, and so on.
Treatment of infantile hemangioma:
Hormone therapy: (apply to the natural regression trend of infantile capillary hemangioma, mixed hemangioma, cavernous hemangioma)
The hormone injection method: in the lesion as interstitial injection with hormone and on the treatment of mixed type hemangiomas effect better, choose methylprednisolone, with saline or lidocaine dilution is injected into the tumor vascular connective tissue stroma, each 2mg / kg (weekly 1 times ", each 4 times for a course of treatment. Usually a course of treatment after the end of the 20~3Od, hemangioma by significantly reduced again to expand, so after an interval of 3 months can repeat a course of treatment, also can choose oral prednisone therapy. Some people reported in the oral prednisone or local vascular tumor interstitial injection of hormone symptoms improved immediately after use. However, the main attention to the use of hormone therapy for infantile hemangioma is long-term effects on the long-term effects of hormones on the metabolism of infants, because long-term hormone therapy may lead to the growth and development of children.
Hormone therapy for infantile capillary hemangioma, mixed hemangioma, cavernous hemangioma. For older children, poor efficacy, no self healing tendency of hemangioma is not suitable for hormone therapy.
Laser treatment: (applicable to a superficial capillary hemangioma and PWS)
There are several types of laser, the traditional carbon dioxide laser, single wavelength laser, photodynamic laser, dual wavelength vascular lesions workstation, etc.. Principle of CO2 laser treatment is absorbed through the organization of high energy laser photothermal reaction, make the local temperature in seconds, suddenly elevated to the number of Baidu or higher, tissue coagulative necrosis, so the skin will damage, also easily lead to infection, scarring and other consequences. Single wavelength laser although compared to traditional carbon dioxide has improved, wound not so serious, leaving scars, reducing the risk of, but because of its limited depth of treatment, for deeper positions, vascular malformations, it is difficult to achieve thorough treatment effect. Laser photodynamic is in recent years capillary hemangioma treatment method in the treatment of port wine stains effect relatively good a treatment plan, but photodynamic for children requiring general anesthesia, and the injection of photosensitizer, postoperative wound, and edema, so it is necessary to stay in the hospital for observation, and then also avoid light a month, the process is relatively complex. In addition there are double wavelengths vascular lesions workstations is the treatment of red stain the new treatment technology, from the point of view of domestic and foreign literature seems to be the treatment effect is good, because our hospital has not yet been carried out the technology and specific bad review.
Radionuclide therapy: (for capillary hemangioma)
Radionuclide is a good method in the treatment of capillary hemangioma, especially for infantile strawberry capillary hemangioma, can be painless, non-invasive, no scar, no side effects of the perfect cure. There are 32 kinds of two phosphorus and 90 strontium in the treatment of capillary hemangioma, of which 32 are short half-life and the treatment is not convenient and so on. Nuclide 90Sr in five categories of radioactive sources in the most weak a, strontium 90 by decay only release trace amounts of pure beta ray belongs to, its effective distance of only 3-4 mm, compared with other radioactive elements, small amount of beta ray of strontium 90, and each treatment time is very short, on the human body structure wouldn't constitute a serious impact.
Propranolol therapy:
In 2008, reported in Bordeaux, France at the children's Hospital of L aut (-Labr (Ze, and in their use of propranolol treatment of a case with severe hemangiomas of cardiomyopathy and other 1 cases with hemangioma of the cardiac output increased from childhood, accidentally found hemangiomas atrophied. In the consent of the children's parents agreed to the premise, they give and 9 cases of maxillofacial hemangioma in children with the use of propranolol, all children's medication after 24 h of hemangioma color becomes shallow, volume of narrow. From the beginning of 2009, our hospital also launched a prospective study of small dose (1mg / kg / D) propranolol in the treatment of infantile hemangioma, found a small dose of oral propranolol ANN (propranolol) treatment of infantile hemangioma good short-term efficacy, adverse reactions are mild, replace the traditional prednisone scheme as the first-line therapy for infantile hemangiomas. Because infants and young children with a small amount, so the need to use under the guidance of a doctor.
Surgical treatment:
Because infants and young children on anesthesia, surgical tolerance is poor, so we do not recommend a positive surgical treatment within 3 years of age. Unless the patient has a rapid growth of hemangioma, serious impact on infant development and life, and other treatment options are invalid, you can consider surgical treatment.
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